Basic Information
| Provider Information | |||||||||
| NPI: | 1033355326 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MACKAY | ||||||||
| FirstName: | CHRISTY | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | PAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 PARK WEST BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308699777 | ||||||||
| FaxNumber: | 3308656011 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 PARK WEST BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308699777 | ||||||||
| FaxNumber: | 3308656011 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2008 | ||||||||
| LastUpdateDate: | 03/01/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 50.001450 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 50-00-1451 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.